Land swap to allow mental health facility
A land swap that required legislative approval and the signature of Gov. Deval Patrick has paved the way for the Martha's Vineyard Hospital to add needed parking spaces at its new facility. And, the arrangement will allow the state Department of Mental Health (DMH) to open a long-sought Island facility.
The deal involves the building and offices of the Vineyard Medical Services walk-in clinic owned by Dr. Michael Jacobs on State Road in Vineyard Haven.
Here are the elements.
DMH owns an approximately 1.7-acre wooded lot located across from the hospital emergency room and behind the State Police barracks in Oak Bluffs.
In December 2006 the Martha's Vineyard Commission (MVC), the Island's powerful regional permitting body, approved the construction of a new Martha's Vineyard Hospital building. That approval came with a list of 68 conditions that included a requirement that the hospital come up with 60 additional parking spaces.
Dr. Michael Jacobs, a veteran Island physician who operates a private walk-in clinic, has for some time wanted to sell his building and retire. That led to discussions with the hospital about the purchase of his building and practice, which provides non-emergency medical care for patients who might otherwise turn to the hospital emergency room.
The plan that came together was that the hospital would purchase the Vineyard Medical Services property and swap it with DMH. The hospital gets parking and DMH gets a building. The hospital would also continue to operate the walk-in clinic.
But before any of those plans could move forward, an act of legislation was needed. Last Tuesday, the governor signed "An Act Relative to Martha's Vineyard Hospital," that authorizes the transfer of the DMH lot to the hospital in return for a lot of land with a building "that is suitable for DMH services."
In a telephone conversation Monday, Tim Walsh, hospital chief executive officer, said Senator Robert O'Leary and Representative Timothy R. Madden were instrumental in seeing the legislation passed.
In a press release, Mr. Madden said, "I'm pleased we were able to pass it before the holidays. This land swap is a win for both the Martha's Vineyard Hospital as well as the Department of Mental Health, which will allow both organizations to provide these vital services for Vineyarders."
Began with lot
Mr. Walsh said the hospital was originally interested in a purchase of the DMH property to solve its parking needs. But DMH was reluctant to sell and give up its only presence on the Island given the need to address the Island's behavioral health needs. DMH was also unwilling to lease the property.
Mr. Walsh said at the time Dr. Jacobs had his property up for sale. That led to a discussion of a land swap. Because DMH was very interested in establishing an outpatient behavioral health clinic and had been in discussions with Martha's Vineyard Community Services the Jacobs property with its existing clinic was very appealing.
"We thought that if we could make this all happen it would be a win-win," Mr. Walsh said.
Mr. Walsh said DMH recognizes the need for ambulatory care for people making the transition from an off Island in-patient facility.
Anna Chinappi, DMH director of communication, said discussions have taken place for the last three years regarding the DMH property. "DMH is very happy to acquire the building and it will be a suitable site for DMH programs," Ms. Chinappi said.
For now, there are no immediate plans. "We look forward to better economic times and economic recovery that will enable us to put this to good use," Ms. Chinappi said. "Currently, there is insufficient funding to establish any new programs in the building but we plan to use this in the future." The building will be maintained and secured she said.
Julia Burgess, community services executive director, told The Times yesterday she has been aware of the DMH property swap and has had very preliminary discussion with DMH about future possibilities. She said the Island does not have the volumes to justify an in-patient crisis stabilization unit, particularly given current budget constraints, but there is a need for an out-patient facility that would assist people integrating back into the community. "When someone comes back off the boat having been in rehab," she said, "there is a tremendous amount of need for that program."
Ms. Burgess said Community Services hopes to have more intensive outpatient support for people wrestling with substance abuse available this winter at its home facility.
Retiring for decades
A long-time Island internist, Dr. Jacobs said the walk-in clinic has provided a unique service for the community and he expects that will be enhanced in the future once the service is better integrated with the hospital and other physician offices. "We already have a very close working relationship," he said.
"I think they are looking to expand the utilization of the office to take some of the strain off the emergency room during peak times, especially in the summer and expand the staff here so patients have access to physicians who admit to the hospital on a regular basis," Dr. Jacobs said. "I think there are a lot of opportunities for improving the availability of doctors and nurse practitioners."
"This office runs only because we have had excellent nurse practitioners like Carol Forgione and Kate Hough, who was here for 25 years," Dr. Jacobs added.
As for retirement, Dr. Jacobs said, "I have been trying to retire for decades." He said his plans are up in the air but he wants to do more teaching and writing and will practice medicine at some level. "And I certainly want to be part of any transition with the hospital," he added.
The hospital began discussions with Dr. Jacobs in Sept. 2007 and signed a purchase and sales agreement on October 28, 2008 conditioned on legislative approval of the land swap. Mr. Walsh said he would not reveal the purchase price at this time.
Mr. Walsh said that throughout the discussions, the importance of the walk-in clinic was paramount. "I think the walk-in provides a pretty significant service on the Island," Mr. Walsh said. "I think there are a lot of people who would just as soon go to a walk-in as opposed to a primary care doctor. It also takes a lot of pressure off the ER."
Mr. Walsh said his plan is to make no changes and run the walk-in in the same way that Dr. Jacobs now operates the clinic. The challenge now he said is to find another location.
Mr. Walsh said he is in discussions with DMH about a short term rental of the space so the hospital could continue to operate the clinic while it makes other arrangements.
With the new hospital building set to open next year one possibility would be to create a walk-in clinic on the hospital grounds. But that is contingent on space needs and it is still under discussion.
All of those discussions have been taking place in the background. Once concluded, the deal was put on hold while the transfer legislation wound its way through the State House. The entire process took more than a year and a half. "Senator O'Leary and Representative Madden were terrific about helping us," Mr. Walsh said.
Several state agencies, including the office of the Inspector General must still sign off on the deal. But for now it is moving forward towards completion.